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Family Cancer Risk Program

Make an Appointment

If your provider has referred you
for genetic testing, call

413-794-8890

When it comes to cancer, we believe knowledge is power. That’s why Baystate Health offers genetic counseling and testing for people with a family history or personal history of cancer. Our goal is to provide the right test, to the right person, at the right time.

Once we know your genetic risk, we’ll work with you to make a plan for preventing cancer and supporting long-term health.

Our team of medical oncologists and genetic counselors will help you navigate what can be a complex process. We provide valuable details about your genetic makeup and clarity on what to do next.

HOW IT WORKS

We can test your genetic risk for breast and ovarian cancer with a blood test. The screening looks for mutations on your BRCA1 or BRCA2 genes. These genes make proteins that can help stop tumors. If either of them is mutated (altered) and not working properly, your risk for breast and ovarian cancer increases.

If you’ve already been diagnosed with cancer, you’ll probably want to have the genetic test done before you start breast cancer treatment. The results of the test may change your care plan and guide decisions you make about treatment.

Whether or not you are found to be at genetic risk, we’ll give you a comprehensive consultation that addresses genetics and provides you with a personalized plan for your risk reduction. This may include recommendations for the frequency of screening procedures, information about chemopreventive agents (drugs used to prevent or delay cancer), and education about lifestyle strategies.

Before Testing

If you are referred for genetic testing, our navigator will work with you by phone or secure email to gather:

  •  A three-generation family cancer history
  •  Information about family members who have had genetic testing
  •  Copies of those test results

Once the information has been collected, your integrated team meets to tailor an individual plan for you. Based on your chance of carrying a gene mutation, you will be scheduled for genetic counseling. The team may recommend that one of your family members have testing first. The best testing laboratory is selected and medical insurance requirements are reviewed. In many cases, the testing process begins immediately after the genetic counseling appointment

After Testing

If your tests reveal a genetic mutation:

  •  You will meet with a genetic counselor to discuss your results.
  •  You will meet with a medical oncologist to develop strategies for cancer risk reduction and surveillance. This may include follow-up in our High Risk Screening Program.

If your tests do not reveal a gene mutation, you may still be at increased risk of developing cancer due to family history or other factors.

  •  You will receive counseling from a nurse practitioner to discuss other factors that may still put you at higher risk.
  •  The nurse practitioner may recommend additional screenings.
  •  You may receive follow-up care through our High Risk Screening Clinic.

Women who are found to be at high risk for breast cancer may choose to have regular follow-up in the High Risk Screening Clinic at the Baystate Breast & Wellness Center.

Regular Follow-Up in the High Risk Clinic Includes:

  • Coordinated annual follow-up visits. You will have same-day appointments for a clinical breast exam and digital mammography, with copies of your reports sent to your primary care provider and/or your women's health provider as you request.
  • Enhanced screening. We may use breast MRI and interpretation if necessary, based on guidelines agreed upon by the Baystate Breast Health Network.
  • Prompt referral. If any concerns arise, we’ll promptly refer you to a breast surgeon.

No test can predict when and if you will have cancer. However, our team of certified genetics counselors and medical oncologists can give you the information you need to make the best decisions for your future health.

Am I a Good Candidate for Cancer Genetic Risk Testing and Counseling?

We work with referring providers in primary care, oncology, and other specialties to be on the lookout for patients whose medical and family histories include certain types of cancer, as well as ages of when cancer has been diagnosed. These can indicate the potential for a genetic risk to develop cancer.

If any of the following apply to you or your family, you may be at increased genetic risk to develop cancer:

  • Cancers diagnosed at a young age (e.g., breast cancer or kidney cancer diagnosed before 45, other cancers diagnosed before age 50, etc.)
  • Diagnosis of 10 or more precancerous (adenomatous) colon polyps, which can indicate an increased risk of colon cancer
  • Diagnoses of certain groupings of cancer (e.g., breast and ovarian cancer, colon and uterine cancer, etc.)
  • Diagnoses of multiple types of cancer for one person
  • Multiple generations of your family diagnosed with the same type of cancer (e.g., three or more family members diagnosed with breast cancer or colon cancer)
  • Rare types of cancer, such as ovarian cancer, pancreatic cancer, or certain types of endocrine tumors

If a Family Member Has Had Cancer, Does That Mean I’ll Have It Too?

Not necessarily. Most cancer is not hereditary. In fact, only 10% to 15% of cancers are known to be caused by a genetic mutation passed down within a family. Even if you test positive for a mutation that may increase your risk for developing a form of cancer, that doesn’t mean you will develop that form of cancer or any other. Lifestyle factors and environmental risks also determine your overall risk for a particular cancer.

How Expensive Is Cancer Genetic Testing?

Many patients are concerned that their genetic testing for cancer risk is going to cost them thousands of dollars. In fact, most pay no more than $250 for their testing, and many pay less than $100. However, your exact cost will depend on your insurance coverage.

How Can a Genetic Risk for Cancer Affect My Treatment Options?

A positive genetic test for cancer risk may impact your available treatment options. A mutation in certain genes can make you a candidate for medications such as PARP (poly ADP ribose polymerase) inhibitors. PARP inhibitors tend to be most effective in people with a genetic predisposition to develop certain kinds of cancers.

If genetic test results indicate you are at increased risk for certain cancers, such as breast cancer or colorectal cancer, your doctor may offer you more intensive surgical treatment options if you do develop those cancers to lower the chance of that type cancer occurring again. For example, you may be a candidate for a bilateral mastectomy (surgical removal of both breasts) if you develop breast cancer, or your doctor may propose surgical removal of some or all of your colon if you develop colon cancer.

How Private Are My Test Results?

Unlike most at-home/recreational genetic testing services, our labs are bound by the Clinical Laboratory Improvements Amendments Act of 1988 (CLIA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA). These laws hold healthcare organizations like us and the genetic testing labs we work with to the strictest standards of quality and confidentiality. We don’t share your results with anyone unless you give us permission to do so (e.g., other members of your family who may be at risk for developing cancer).

Should I Have Genetic Testing? Are There Any Negatives to Being Tested?

Some people may decide not to move forward with genetic testing (or postpone it). Some anticipate that they would be highly worried about developing cancer if their test results are positive. Others feel they would not be willing to undergo the extra screening, preventative surgeries, or take preventative medication recommended after a positive result. Another common concern is the impact of positive genetic test results on certain types of insurance.

As noted in the Genetic Information Nondiscrimination Act of 2008 (GINA), most employers and health insurance providers can’t hold your genetic information against you. That means it’s illegal for you to face any negative effects at your job or from your health insurance if your genetic testing shows an increased risk for developing cancer. However, that protection does not apply to several other types of insurance, such as:

  • Disability insurance
  • Life insurance
  • Long-term-care insurance

This may mean you will want to obtain these types of insurance before you undergo genetic testing, as your rates/premiums may be affected by a positive test result.

We’ll work with you during your initial genetic counseling visit so you understand the benefits and any potential disadvantages of genetic testing so you can make the best possible decision for yourself.

Learn more about GINA, its protections, and what you should know about genetic discrimination.  

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